Provider Demographics
NPI:1912452053
Name:CHILUKA, SUDHIR KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHIR KUMAR
Middle Name:
Last Name:CHILUKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 W GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-2408
Mailing Address - Country:US
Mailing Address - Phone:601-825-8130
Mailing Address - Fax:601-825-8130
Practice Address - Street 1:1551 W GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-2408
Practice Address - Country:US
Practice Address - Phone:601-825-8130
Practice Address - Fax:601-825-8130
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS30634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine